# EAST VALLEY PHOENIX ASC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417530296
- **Authorized official:** GREGG MILLER MD (SENIOR VICE PRESIDENT)
- **Authorized official phone:** (610) 644-8900

## Contact information

- **Practice address:** 4555 E INVERNESS AVE STE 101, MESA, AZ 85206-4630
- **Practice address phone:** (610) 644-8900
- **Mailing address:** 40 VALLEY STREAM PKWY STE 100, MALVERN, PA 19355-1407
- **Mailing address phone:** (610) 644-8900
- **Mailing address fax:** (484) 924-0053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/30/2021
- **Last updated:** 04/30/2021